Parameters of postocclusive reactive hyperemia measured by near infrared spectroscopy in patients with peripheral vascular disease and in healthy volunteers.

Abstract

The main purpose of our study was to determine the parameters of the postocclusive reactive hyperemia test that could help and provide the clinician with information about the tissue oxygenation, the severity of the disease, and the results of the applied therapies. Near infrared spectroscopy (NIRS) proved to be a valid noninvasive trend monitor useful for investigating the physiology of oxygen transport to tissue. Important advantages of NIRS over transcutaneous oximetry (TcpO2) are: (a) a more dynamic nature of the NIRS signals which reflects more closely the actual response of the peripheral vasculature to the occlusive provocation; (b) larger sampling volume; and (c) the ability of assessing tissue oxygenation at deeper tissue levels. We demonstrated that the time parameters of reactive hyperemia, the rate of reactive hyperemia, and the maximal change during reactive hyperemia, all calculated from the oxyhemoglobin (HbO2) signal of the NIRS, clearly distinguish between healthy volunteers and patients with vascular disorder. The time parameters of reactive hyperemia were significantly longer (p<0.01), and the rate of reactive hyperemia (p=0.01) as well as the maximal change during reactive hyperemia (p=0.02) were significantly lower in patient group compared to healthy volunteers. These parameters were also in good correlation with the values of ankle brachial index (ABI) and the resting values of oxygen partial pressure (TcpO2). Values of the chosen parameters obtained from the HbO2 signal were further compared between groups of diabetic and nondiabetic patients with peripheral vascular disease. Although longer time parameters of reactive hyperemia and lower rates of hyperemic response were detected, the difference between both groups was not statistically significant.